Healdsburg, CA · Sonoma County
Electric Green Rate Election
Healdsburg utility customers use this application to elect the Electric Green Rate and agree to its terms, including the additional per-kilowatt-hour charge.
What this form is
This application lets a Healdsburg utility customer elect the Electric Green Rate, under which the city procures renewable energy to match monthly energy consumption. It asks for the account number, account holder name, service address, signature, and date, and states the rate terms, including the additional charge and minimum 12-month enrollment. The rate takes effect on the first day of the billing cycle following election.
Who needs it
A Healdsburg utility account holder who wants to enroll in the Electric Green Rate should complete and sign this application.
How to submit it
Send the completed application to Utility Billing/Finance Department, City of Healdsburg, 401 Grove Street, Healdsburg, CA 95448, or email [email protected]. The form also lists fax number (707) 431-3171.
About notarization
This document is signed without a notary; the account holder signs and dates a declaration certifying the information is true and correct under penalty of perjury.
How to submit this form
- 1
Download The Application
Download the Electric Green Rate Election application from this page.
- 2
Complete Account Details
Enter the account number, account holder name, and service address, then review the listed rate terms.
- 3
Sign And Date
Sign and date the declaration certifying that the information is true and correct under penalty of perjury.
- 4
Submit To The City
Send the completed application to Utility Billing/Finance Department by mail, email, or fax using the contact details on the form.
Frequently asked questions
- What does the Electric Green Rate election do?
- It lets a Healdsburg utility customer elect a rate under which the city procures renewable energy to match the customer's monthly energy consumption.
- Do I need a notary for the Electric Green Rate Election?
- No. The account holder signs and dates the declaration, which certifies under penalty of perjury that the information is true and correct; no notary block is included.
- How do I submit the Electric Green Rate Election?
- Send it to Utility Billing/Finance Department at 401 Grove Street, Healdsburg, CA 95448, email [email protected], or fax (707) 431-3171.
Need something notarized?
This Electric Green Rate Election doesn’t need a notary — but if you have another Healdsburg form that does, a commissioned online notary can help.